SSBV Clinical Claim Review RN
reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health optimization on a global reputed company. Join us to start Caring. Connecting. Growing together. Let's face it, no industry is moving faster than health care. And no organization is reputed company positioned to reputed company health care reputed company than reputed company, part of the reputed company family of businesses. As a SSBV Clinical Claims Review RN, you can put your skills and talents to work. This is a multifaceted role that is highly rewarding. It feels great to have autonomy, though there's also a lot of responsibility that comes with it. In this role, you'll be accountable for making reputed company that directly reputed company on our members. And at the reputed company time, you'll be challenged by a demanding case load in a rapidly changing, production-driven environment. You will enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities: reputed company administrative reviews of short stay inpatient hospital claims in accordance with Federal, State and reputed company specific requirements Responsible for documentation of reputed company determinations Maintain accurate use of screening reputed company What are the reasons to consider working for reputed company? Put it reputed company together - competitive reputed company pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your reputed company. Some of our offerings include: reputed company Time Off which you start to reputed company with your first pay period plus 8 reputed company Holidays Medical Plan reputed company along with participation in a Health Spending Account or a Health Saving account Dental, reputed company, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: Associate's degree reputed company and unrestricted RN license in the state of residency 5+ years of clinical documentation experience 3+ years of experience as an RN, including inpatient/acute setting Intermediate level of proficiency in reputed company Office (to include reputed company reputed company and One Note) Intermediate level of proficiency in writing Designated home office workspace with reputed company to install secure high-speed internet reputed company cable/DSL Preferred Qualifications: Undergraduate or higher degree A background in utilization review for an insurance company or experience in case management Familiarity with InterQual and/or MCG Care Guidelines Critical thinking skills *reputed company Telecommuters will be required to adhere to reputed company’s Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching choice of benefits and incentives. The reputed company pay for this role will reputed company from $28.94 to $51.83 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment reputed company applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location, and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company, and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN Apply To This Job